Individual
STEPHEN G. JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1331 JACK LN, CHEYENNE, WY 82009-1874
(423) 596-1116
Mailing address
820 S MACARTHUR BLVD STE 105-314, COPPELL, TX 75019-4216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD0000021820
TN
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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